Provider Demographics
NPI:1700316791
Name:SOUBIH, EVEREST GEFEH (PHARMACIST)
Entity type:Individual
Prefix:
First Name:EVEREST
Middle Name:GEFEH
Last Name:SOUBIH
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:DR
Other - First Name:EVEREST
Other - Middle Name:
Other - Last Name:SOUBIH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:EVARISTUS G SOUBIH
Mailing Address - Street 1:10401 COLUMBIA FALLS DR
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93312-1862
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:707 W LACEY BLVD
Practice Address - Street 2:
Practice Address - City:HANFORD
Practice Address - State:CA
Practice Address - Zip Code:93230-4326
Practice Address - Country:US
Practice Address - Phone:559-584-1896
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-13
Last Update Date:2017-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA76121183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist